State-Level Trends in Employer-Sponsored Health Insurance

A State-by-State Analysis

Recent analysis of ESI coverage provides a baseline to facilitate monitoring Affordable Care Act expansions of public and private coverage in 2014.

This study from the Robert Wood Johnson Foundation-funded State Health Access Data Assistance Center (SHADAC) found that health insurance coverage from employer-sponsored insurance (ESI) “eroded substantially” from 1999/2000 to 2010/2011 (study period).

Key Findings:

The percentage of nonelderly people with ESI declined 10.2 percentage points (PPs) from 69.7 percent to 59.5 percent over the study period while public coverage increased 3.1 PPs.

While most states saw “significant declines” in ESI coverage, the range was wide—from New Hampshire (73.8% coverage) to New Mexico (48.0% coverage).

ESI coverage varied by income. It fell less (2.8 PPs) for high-income groups (400% federal poverty level [FLP] or above) than for those with lower incomes (200 FPL or below) where the fall was 10.1 PPs.

"There is wide variation across states in the ESI measures analyzed here,” the authors conclude. “This variation points to the importance of monitoring and evaluating the impacts of the ACA on ESI at the state level.”